October

Wow I can hardly believe that October is almost over! In just a few short days I will be finished with my General Surgery rotation and one of the busiest portions of my residency. The past four months have gone by quickly. I guess I’m making good progress!

This month has been an interesting one for us.

Abraham is finalizing his applications for residency. We have spent long hours and late nights agonizing over the decision of which specialty to choose and working on his application and essays. Applications are due Mon/Tuesday so we are down to the wire. I’ll keep you posted on what he chooses.

I have been sick the entire month of October and the end of September. My goal is to be sick the entire month so my current team will only know me as someone with a cough. It has been pretty nasty and my physician confirmed that I do likely have a fractured rib from coughing. I guess that can happen—maybe I’m frail, I don’t quite understand it myself. I’m amazed at how much it hurts. I am lucky the cough is slowly going away because it is agonizing to cough, laugh, deep breathe, sit up from bed, etc. I am taking codeine and wearing a tight sports bra but there isn’t anything else I can do.

I got a new pager. This doesn’t seem like a big deal but I miss my old one. This one is very loud. The menu is inconsistent, I can’t keep it on silent without it still beeping sometimes, and I miss the simplicity of my old one. The 100 hospital employees who receive the most pages received new pagers due to an overload on the other pager frequency. I evidently made the cut, and was “Actually one of the very only ones to receive one in your whole department.” I guess this could mean two things, “I work harder than everyone else in my whole department” or “I should feel relieved to be back on Oral Surgery in a few short days.” Maybe I’ll keep thinking both!

Another reason to like Oral Surgery, we have had three patients pass away this month, two more since my last post. Luckily that doesn’t happen much in the dental world. The last one was a surprise, I just sent him home 2 days ago and he was well enough to go home. Wow.

Happy Halloween!

Amp

This week I had my first patient die. She had a heart attack unexpectedly. It is a surreal experience to see a patient “coding” as they call it. Trying to bring them back is an experience full of chaos, almost violence as CPR is performed hard enough to reach through the ribs to the heart, people calling out loudly, rotating turns doing CPR compressions, pushing medications. Death is such a serious thing. A final thing. An obviously life changing thing. But when your job is to work with people who are sick and could die, it is a very strange thing. When I heard about the patient I was eating crackers. We walked over to the heart center where the cardiology team had been working on her before her heart stopped. When we arrived we briefly saw the masses of people trying desperately to bring her back. Her family was crying in the hallway. We left to get out of their way. I hoped the family didn’t ask me about what was happening to their mom and wife. And then, not knowing what to do next, I went back to eating my crackers. It seemed wrong. It seemed insensitive. But there was nothing I could do for her. Work had to be done. And I was hungry.

This week I also made it to the OR for the first time on Vascular Surgery. I got to perform my only requested surgery, an amputation.  A man had a non-healing toe infection. I performed an amputation of the big toe. I was worried I might think it was a little too gross. Cutting on a draped off piece of  skin or working inside the mouth is something I can do and focus on the procedure. But toes are PEOPLE’s toes. You can’t trick your mind into thinking it is just a procedure not attached to a person. It is someone’s toe. But I did fine--and don’t judge me when I say it was really fun--until I handed the  “specimen” off to the nurse. I realized then, “Oh that is someone’s toe!”

Death of a patient and death of a toe. Big events for the patients involved. Just another day in the life of a resident.

Nature

Last night we went camping at a local campsite with friends. Abe brought some muffins for breakfast the next day. While unpacking, we left the hatchback open to my car.

Me: “Honey, did you sneak a taste of one of the muffins?”

Abe: “No, why?”

Me: “Hmm, that’s weird because it looks like someone ate one of the muffin tops.”

I walk to the car and get in the front seat. I hear a rustling noise in the back. I look back to see one of these little buddies in the back of the car munching away.

 

 

Me: I squealed!

Little buddy: luckily ran away under the car, and not further INTO the car. He had found the package of muffins, chewed through the plastic, and ate the muffin top of one. I guess he knows the best part of a muffin, too.

He continued to stalk us all night, coming within only 10 or so feet of us while we ate our dinner. He must have liked the muffin and wanted more!

Sneaky little thing!

Tick Tock

It is October now. That means I have three weeks left of General Surgery! August at the VA was incredibly busy. September was much more manageable on the Surgical Oncology team. I actually got to do some surgeries on my own, just me and the staff surgeon. I performed some melanoma excisions, lymph node biopsies, breast biopsies and lumpectomies, and even a plastic surgery case with skin grafting. It was really fun and I learned so much. In the beginning I was yelled at for my poor knot tying skills which despite my out of the OR practice, were difficult with the anxiety of the OR and the surgeon watching my every move. By the end I had a famous surgeon tell me I have "good hands and a good surgical base." Compliments can be few and far between so I will take it! I really felt that I made some big improvements in a short period of time, going from feeling completely inept to realizing I just need more practice and am doing just fine.

This month I am on vascular surgery. It is probably the least busy rotation yet on GS, at least as far as the at work time. I have very few inpatient responsibilities which leaves me feeling a little lost, "Are you sure you don't need me to do this?" I mostly seen clinic patients. These surgeons do some very interesting things that are mostly over my head. I realized I would much rather look at black teeth than black toes. And am so grateful I can walk without pain. I need to cut down my cholesterol.

Overall, I am getting excited to head back to my oral surgery team in less than a month. I know my forearms will ache after my first few procedures. I know I will be taking more call. And I know I will be a little out of practice. But I also will know a lot more about what is going on and I know I will be doing things every day that I love. Everyone has said that the second year is probably the hardest. I'm getting there!